HomeMy WebLinkAbout424 PINE ST - PERMITS - 9/27/1985City of Fort Collins BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERhUT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address it P/NC
Name L��g/G%2 COMrrtUA/fj� �C—TL t/iGE
`m
Mail Address
3
O
Phone
Name i,4_T11_ /^/C-
O
u
m
Address
C
0
O
License No.
Phone
i
Lot
Block
Filing Number
N
Subdivision
m
0
PUD
rn
J
DESCRIPTION OF WORK
U joCa_ &2ouNi S nib
Stock Options
Plan No. Codes
Est. Total Cost
(including labor, material, profit)
I hereby acknowledge that I have read this application and
state that the above is correct and agree to comply with all city
ordinances and state laws regulating building construction.
signed \ cute
— CLASS OF WORK —
New Alteration Addition Demolish Move
❑ ❑ ❑ ❑ ❑
Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ. Gr.
Type Const.
Use Zone
Use of Building
Floor Area
Height
No. Stories
Lot Area
Frontage
Occ. load
Occ. Change from
Plat File No.
No. D.U.
Garage area
Fin. Bsmt. area
Type heat
No. Fireplaces or stoves
— RELEASES — Dates
Zoning
Engineering
Fire Department
Electric Department
Water & Sewer
Plan Review
Special Conditions:
Valuation FEES
Plan Check
Permit
Parkland
City Sales Tax
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
Total Fees
Distribution Original - Appllcant;'.Blue cOffice ):anary - Sales Tax'. Plnk - Applicant Tag - Bldg. Insp.
Off -Street Parking
(No.
Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot
❑
R
N
cc
`m
(D
r
co
c
0
l
Street
c
0
ZBA Case #
Date
BBA Case #
Date
Building
Insp. Approval
by
date
le)3
l
,-1
Permit No.
Date